A comparison of breast cancer prognostic tools; NPI+ and IHC4, and a development of IHC4 score calculator

Koufeya, Dooa (2015) A comparison of breast cancer prognostic tools; NPI+ and IHC4, and a development of IHC4 score calculator. [Dissertation (University of Nottingham only)]

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This work compares two breast cancer prognostic tools; NPI+, and IHC4 to investigate the accuracy of their predictability, it also includes development of software that calculates IHC4 score. The two prognostic tools (NPI+ and IHC4) were developed to estimate risk of distant recurrence of the cancer based on clinical and biological features of breast cancer patient. The comparison was carried to reveal the superiority of one over the other, and aids clinicians to apply the proper tool for BC diagnostic.

In order to conduct the comparison, NPI+ and IHC4 scores were calculated for a cohort of 173 women aged 70 years or less and diagnosed with invasive BC. These scores were categorised into three different prognosis and risk of recurrence groups, accepting significant differences only if p-value <0.5. While adjusting traditional NPI scores as a reference in the comparison, the categorised scores from the three tools and correspondent time to death and time to metastasis recurrence were plotted using stratified Kaplan-Meier curves. In addition, concordance between NPI+ and IHC4, in term of allocating patients into different prognosis and risk of recurrence groups, was investigated using cross-tabulation. Utilising the published algorithm of IHC4 tool, the IHC4 score calculator was developed using GUI builder for Java. No significant difference was observed in this study between NPI+ and IHC4 tools in categorising BC patients based on disease prognosis and risk of recurrence. Several advantages were associated with using NPI+, such as being applicable to all BC patients aged 70 years or less, while IHC4 is compatible with patients with specific characteristics only. On the other hand, IHC4 has an advantage over NPI+ because of its cost, which is far less than the cost of NPI+. Further studies are required to compare two tools and generate mathematical-based evidence.

Item Type: Dissertation (University of Nottingham only)
Depositing User: Gonzalez-Orbegoso, Mrs Carolina
Date Deposited: 09 Dec 2015 15:32
Last Modified: 13 Sep 2016 12:04
URI: http://eprints.nottingham.ac.uk/id/eprint/30829

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